Ventilatory Support, Extubation and Cerebral Perfusion Changes in Preterm: a NIRS study

Objective: to investigate any change in cerebral oxygenation (rScO2) and fractional tissue oxygen extraction (cFTOE) after extubation in preterm infant. Study design: single-centre observational study with retrospective analysis of near infrared spectroscopy (NIRS) data of all consecutive preterm patient born at our institution in 1 year. Correlation analysis and comparison between subgroups was made. Result: 19 patients were included; average gestational age (GA): 29,4 weeks.No significant change was noted in rScO2 and cFTOE after extubation in whole population. A correlation between GA, GMH-IVH and DrScO2, DcFTOE were noted. A significant increase of cFTOE was noted in patient with previous GMH-IVH (+0.040; p=0.036). Conclusion: extubation per se is not linked with significant change in cerebral oxygenation and perfusion. Patient with GMH-IVH shows an increase in cFTOE suggesting a perturbation in cerebral perfusion.Further observations on larger populations should corroborate this data highlighting cautious extubation in preterm babies with GMH-IVHpe

Nietzsche's and Pessoa's Psychological Fictionalism

In a note to G.R.S. Mead’s "Quests Old and New", where he found a section devoted to Hans Vaihinger’s main ideas, Fernando Pessoa reflects on the consequences of the fictionalist approach to both our perception of the I and the value of consciousness. These questions correspond to some statements that we find in Nietzsche’s writings, which in particular Vaihinger refers to in his Die Philosophie des Als-ob. Our aim is thus to compare Nietzsche’s and Pessoa’s view of the I and consciousness, and to deal with their psychology by making reference to Vaihinger’s fictionalism

Le Fondazioni di origine bancaria: dal controllo delle banche al non for profit

Questo elaborato descrive l'evoluzione normativa delle fondazioni di origine bancaria , soffermandosi in modo particolare sul potere di controllo e vigilanza ad opera del Mef e gli ultimi sviluppi riguardanti la partecipazione della fondazione nella banca conferitari

"Vivem em nós inúmeros":filosofias em Fernando Pessoa

Tese de doutoramento, Filosofia (Filosofia em Portugal), Universidade de Lisboa, Faculdade de Letras, 2012Pela impressionante heterogeneidade de conteúdos e tópicos que Fernando Pessoa desenvolveu nos escritos que redigiu durante pouco mais de trinta anos, testemunhos de um autêntico universo de mundividências e perspectivas, o conjunto desses escritos deixou de ser, há algum tempo, um filão de estudo meramente literário, abrindo-se, em simultâneo, a análise de investigadores de todos os domínios das ciências humanas. Menção especial merece a filosofia, objecto de estudo de Pessoa desde muito cedo (logo a partir da efémera experiência universitária: 1905-1907), fonte de uma inquietação onto-gnoseologica nitidamente revelada quer na obra em verso, quer na obra em prosa. Escritor interessado nas disputas mais antigas e aparentemente irresolúveis do pensamento planetário a volta do Ser, do Real e das antinomias mesmo-outro, singularidade-pluralidade, Ilusão-Verdade; interlocutor dos diálogos entre a Poesia e Filosofia, a Verdade e a Mentira, a Ficção e a Realidade; Pessoa pertence a uma família de poetas e pensadores tais como Teixeira de Pascoaes, Giacomo Leopardi, Arthur Schopenhauer, Jorge Luís Borges, Friedrich Nietzsche e Nishida Kitarō, entregues como ele, a inadiável tentação de procurar um sentido para o nosso mundo na poiésis artística.Due to the heterogeneity of contents and topics underlying Fernando Pessoa’s thirtyyear production (a unique universe of worldviews and perspectives), the study of his writings is not exclusively limited to the field of literature, but rather to every domain of the human sciences. In this regard Philosophy deserves a special mention. Object of interest for Pessoa from very early on (ever since his ephemeral university experience between 1905 and 1907), Philosophy stems from his onto-gnoseologic pursuits, which in turn pervade his poetry and prose texts. Pessoa was a writer interested in the most ancient and apparently irresoluble disputes of human thought concerning Being, Reality and the antinomies sameness-otherness, singularity-plurality, and Illusion-Truth. He belongs to a family of poets and thinkers such as Teixeira de Pascoaes, Giacomo Leopardi, Arthur Schopenhauer, Jorge Luis Borges, Friedrich Nietzsche and Nishida Kitarō, who also gave themselves to the pressing temptation of seeking meaning to our world through the artistic poiesis.Camões - Instituto da Cooperação e da Língua, I.P ; Fundação para a Ciência e a Tecnologia (FCT

Anatta- e Anicca nella poetica ionterstiziale di Fernando Pessoa

Tendo como prerrogativa o desmascaramento da pretensão, inserida em qualquer essência fenoménica e psicológica, de afirmar-se como uma entidade autónoma, isolada e independente, como puro “em si”, e à revelação de como, contrariamente, qualquer realidade empírica tenha de tal forma uma natureza impermanente subentendendo-se como uma rede de relações e de interligações, a teoria da anatta-, juntamente coma da anicca, representam no âmbito do ensinamento budista talvez o que mais se assemelha ao conceito de askesis filosófica formulado no Ocidente por uma certa tradição de pensamento tendo como raízes Heraclito, Platão, Hegel e Nietzsche e que descobre dois de entre os mais originais intérpretes em Novalis e Pessoa. De facto, quer no primeiro quer no segundo, o filosofar configura-se como uma arte de compor e recompor-se a si mesmo, um percurso de iniciação a si que passa inexoravelmente pelo abandono da posição da própria auto-referencialidade e da aceitação ontognoseológica do outro no seio do idêntico. Mediante esta operação de descentralização, que em Pessoa começa e se dissolve no interior da estratégia estética da heteronímia, onde apalavra poética transfigura-se no interstício, na abdicação e fingimento, o sujeito descobre-se diferença e relação e é-lhe finalmente possível reconhecer-se como totalidade e de reflectir-se nela

Oxidative stress as a primary risk factor for brain damage in preterm newborns

The risk of oxidative stress is high in preterm newborns. Room air exposure of an organism primed to develop in a hypoxic environment, lacking antioxidant defenses, and subjected to hyperoxia, hypoxia, and ischemia challenges the newborn with oxidative stress production. Free radicals can be generated by a multitude of other mechanisms, such as glutamate excitotoxicity, excess free iron, inflammation, and immune reactions. Free radical-induced damage caused by oxidative stress appears to be the major candidate for the pathogenesis of most of the complications of prematurity, brain being especially at risk, with short to long-term consequences. We review the role of free radical oxidative damage to the newborn brain and propose a mechanism of oxidative injury, taking into consideration the particular maturation-dependent vulnerability of the oligodendrocyte precursors. Prompted by our observation of an increase in plasma Adenosine concentrations significantly associated with brain white matter lesions in some premature infants, we discuss a possible bioenergetics hypothesis, correlated to the oxidative challenge of the premature infant. We aim at explaining both the oxidative stress generation and the mechanism promoting the myelination disturbances. Being white matter abnormalities among the most common lesions of prematurity, the use of Adenosine as a biomarker of brain damage appears promising in order to design neuroprotective strategies

A Prospective, Randomized Trial of Structured Treatment Interruption for Patients with Chronic HIV Type 1 Infection

Background. Structured treatment interruption was evaluated in 74 patients who had been pretreated with antiretrovirals, consisting of 2 nucleoside reverse-transcriptase inhibitors (NRTIs) for 1 year followed by 3 years of highly active antiretroviral therapy containing a protease inhibitor. Methods. Patients with a CD4 cell count of ⩾350 cells/µL and a plasma viral load of <50 copies/mL were randomized to 3 therapy arms: (1) continuous therapy, (2) CD4 cell count—guided theory, and (3) week-on/week-off (WOWO) therapy. The efficacy and safety of structured treatment interruption and antiretroviral use were evaluated in human immunodeficiency type 1 (HIV-1)—infected patients. The study end points were percentage of patients who developed AIDS or who died and a CD4 cell count of ⩾350 cells/µL. Intergroup differences were analyzed using analysis of variance and Kruskal-Wallis tests. Results. Baseline characteristics at the start of the structured treatment interruption were similar. At week 48, no patient had died, and 1 patient in the WOWO group had an AIDS-defining condition. The proportions of patients with a CD4 cell count of ⩾350 cells/µL were 100%, 87%, and 96% in treatment arms 1, 2, and 3, respectively. The percentages of weeks of antiretroviral use were 100%, 41.1%, and 69.8% in arms 1, 2, and 3, respectively. The adverse events were not significantly different among arms (P = .27). Thirty-one percent of patients in the WOWO group experienced virological failure. Conclusion. WOWO therapy maintained a CD4 cell count of ⩾350 cells/µL in almost all patients but was associated with high virological failures rates (possibly resulting from previous dual-NRTI therapy), indicating that this strategy is less useful. Receipt of CD4 cell count—guided therapy resulted in comparable clinical outcomes to continuous therapy and may save antiretroviral-associated costs, but this needs to be confirmed by a larger tria

Development and validation of serum bilirubin nomogram to predict the absence of risk for severe hyperbilirubinaemia before discharge: a prospective, multicenter study

Early discharge of healthy late preterm and full term newborn infants has become common practice because of the current social and economic necessities. Severe jaundice, and even kernicterus, has developed in some term infants discharged early. This study was designed to elaborate a percentile-based hour specific total serum bilirubin (TSB) nomogram and to assess its ability to predict the absence of risk for subsequent non physiologic severe hyperbilirubinaemia before discharge

safety and efficacy of galactogogues substances that induce maintain and increase breast milk production

Poor production of breast milk is the most frequent cause of breast lactation failure. Often, physician prescribe medications or other substances to solve this problem. The use of galactogogues should be limited to those situations in which reduced milk production from treatable causes has been excluded. One of the most frequent indication for the use of galactogogues is the diminution of milk production in mothers using indirect lactation, particularly in the case of preterm birth. The objective of this review is to analyze to the literature relating to the principal drugs used as galactogogues (metoclopramide, domperidone, chlorpromazine, sulpiride, oxytocin, growth hormone, thyrotrophin releasing hormone, medroxyprogesterone). Have been also analyzed galactogogues based on herbs and other natural substances (fenugreek, galega and milk thistle). We have evaluated their mechanism of action, transfer to maternal milk, effectiveness and potential side effects for mother and infant, suggested doses for galactogogic effect, and recommendation for breastfeeding

HIV-Specific Cellular Immune Responses Are Stimulated by Structured Treatment Interruption in Chronically HIV-1 Infected Koreans

We evaluated the enhancing effect of structured treatment interruptions (STIs) on HIV-specific immunity in chronically HIV-1 infected Korean patients. A prospective case-control study was done with a total of 10 subjects for a period of 26 weeks. Six subjects were on STIs and four subjects were on continuous HAART for comparison. The STI subjects underwent four periods of STIs. For those on STIs, HAART was stopped at week 0 for two weeks, and resumed thereafter for six weeks. Viral load and CD4+/CD8+ T cells were measured by HIV RNA RT-PCR and flow cytometry, and HIV-specific immunity was measured by an ELISPOT assay. HIV-specific cytotoxic T cell immunity was more pronounced in the STI subjects than in the continuous HAART subjects after 26 weeks (p = 0.011). The difference in cytotoxic T cell response in the STI group was more prominent than in the continuous HAART group (p = 0.011). Viral load after 26 weeks was higher in the STI subjects than in the continuous HAART subjects (p = 0.008). An HIV-specific cellular immune response can be stimulated by STIs in chronically HIV-infected Koreans. A larger study is warranted in order to further characterize viral and immunological parameters of treatment with STIs in cases of chronic HIV infection